Notice of Pre-AIA or AIA Status
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Notice to Applicant
This communication is in response to the amendment filed 09/22/2026. Claims 1, 9, 17 have been amended. Claims 1-20 are presented for examination.
Claim Rejections - 35 USC § 101
35 U.S.C. 101 reads as follows:
Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title.
Claims 1-20 are rejected under 35 U.S.C. 101 because the claimed invention is directed to a judicial exception (i.e., a law of nature, a natural phenomenon, or an abstract idea) without significantly more. Based upon consideration of all of the relevant factors with respect to the claims as a whole, the claims are directed to non-statutory subject matter which do not include additional elements that are sufficient to amount to significantly more than the judicial exception because of the following analysis:
Claim 1 is drawn to a method which is within the four statutory categories (i.e., method). Claim 9 is drawn to a system which is within the four statutory categories (i.e., machine). Claim 17 is drawn to a non-transitory, computer-readable medium which is within the four statutory categories (i.e., manufacture).
Independent claim 9 (which is representative of independent claims 1, 17) recites… maintain a database of surgical implant device information and associated pricing information, the device information comprising historical pricing information based on the device type information associated with the surgical implant device, wherein the historical pricing information comprises, for each device, prices for the device over time, wherein the price for each device is adjusted for inflation over the period of time; receive an electronic record for a medical bill; determine whether to review the electronic record for the medical bill based on information within the electronic record indicating use of a surgical implant device; in response to determining to review the electronic record for the medical bill, determine a price for the surgical implant device based on the electronic record for the medical bill and the database of surgical implant device information and associated pricing information; and provide…the determined price for the surgical implant device as a recommended payment amount for the surgical implant device.
Under its broadest reasonable interpretation, the limitations noted above, as drafted, covers certain methods of organizing human activity (i.e., managing personal behavior or relationships or interactions between people…following rules or instructions), but for the recitation of generic computer components. The claims encompass a series of rules or instructions for a person or persons to follow, with or without the aid of a computer, to collect data, analyze the collected data, and output a determination (i.e., review pricing) (i.e., ¶ 0002 of the specification describes “medical bills with surgical implants are reviewed using manual processes,” which is human activity) in the manner described in the identified abstract idea, supra. The rules or instructions are the claimed steps, as indicated supra. That is, other than reciting generic computer components (discussed infra), the claim amounts to managing personal behavior or relationships or interactions between people following rules or instructions. If a claim limitation, under its broadest reasonable interpretation, covers managing personal behavior or relationships or interactions between people, but for the recitation of generic computer components, then it falls within the “Certain Methods of Organizing Human Activity” grouping of abstract ideas. Accordingly, the claims recite an abstract idea.
Claim 1 recites additional elements (i.e., a processor of a billing review system; a graphical user interface). Claim 9 recites additional elements (i.e., A system comprising: a display device; a processor coupled with the display device; and a memory coupled with and readable by the processor and storing therein a set of instructions; a graphical user interface rendered on the display device). Claim 17 recites additional elements (i.e., A non-transitory, computer-readable medium comprising a set of instructions; a processor; a graphical user interface). Looking to the specifications, a computing system having a processor, display device with a graphical user interface, memory, non-transitory, computer-readable medium comprising a set of instructions is described at a high level of generality (¶ 0021-0022; ¶ 0025-0027; ¶ 0032; ¶ 0038-0042), such that it amounts to no more than mere instructions to apply the exception using generic computer components. Looking at the limitations as an ordered combination adds nothing that is not already present when looking at the elements individually. The additional elements do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea. Accordingly, the claims are directed to an abstract idea.
Reevaluated under step 2B, the additional elements noted above do not provide “significantly more” when taken either individually or as an ordered combination. The use of a general purpose computer or computers (i.e., a computing system having a processor, memory, non-transitory, computer-readable medium comprising a set of instructions) amounts to no more than mere instructions to apply the exception using generic computer components and does not impose any meaningful limitation on the computer implementation of the abstract idea, so it does not amount to significantly more than the abstract idea. Looking at the limitations as an ordered combination adds nothing that is not already present when looking at the elements individually. The combination of elements does not indicate a significant improvement to the functioning of a computer or any other technology and their collective functions merely provide a conventional computer implementation of the abstract idea. Furthermore, the additional elements or combination of elements in the claims, other than the abstract idea per se, amount to no more than a recitation of generally linking the abstract idea to a particular technological environment or field of use, as the courts have found in Parker v. Flook; similarly, the current invention merely limits the claimed calculations to the healthcare industry which does not impose meaningful limits on the scope of the claim. Therefore, there are no limitations in the claims that transform the judicial exception into a patent eligible application such that the claims amount to significantly more than the judicial exception.
Dependent claims 2-8, 10-16, 18-20 include all the limitations of the parent claims and further elaborate on the abstract idea discussed above and incorporated herein.
Claims 2-8, 10-16, 18-20 further define the analysis and organization of data for the performance of the abstract idea and do not recite any additional elements. Thus, the claims do not integrate the abstract idea into a practical application and do not provide “significantly more.”
Although the dependent claims add additional limitations, they only serve to further limit the abstract idea by reciting limitations on what the information is and how it is received and used. These information characteristics do not change the fundamental analogy to the abstract idea grouping of “Certain Methods of Organizing Human Activity,” and, when viewed individually or as a whole, they do not add anything substantial beyond the abstract idea. Furthermore, the combination of elements does not indicate a significant improvement to the functioning of a computer or any other technology. Therefore, the claims when taken as a whole are ineligible for the same reasons as the independent claims.
Claim Rejections - 35 USC § 103
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
This application currently names joint inventors. In considering patentability of the claims the examiner presumes that the subject matter of the various claims was commonly owned as of the effective filing date of the claimed invention(s) absent any evidence to the contrary. Applicant is advised of the obligation under 37 CFR 1.56 to point out the inventor and effective filing dates of each claim that was not commonly owned as of the effective filing date of the later invention in order for the examiner to consider the applicability of 35 U.S.C. 102(b)(2)(C) for any potential 35 U.S.C. 102(a)(2) prior art against the later invention.
The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
The factual inquiries set forth in Graham v. John Deere Co., 383 U.S. 1, 148 USPQ 459 (1966), that are applied for establishing a background for determining obviousness under 35 U.S.C. 103 are summarized as follows:
1. Determining the scope and contents of the prior art.
2. Ascertaining the differences between the prior art and the claims at issue.
3. Resolving the level of ordinary skill in the pertinent art.
4. Considering objective evidence present in the application indicating obviousness or nonobviousness.
Claim(s) 1-5, 9-13, 17-18 is/are rejected under 35 U.S.C. 103 as being unpatentable over U.S. Patent App. Pub. No. US 2016/0063199 A1 (hereinafter referred to as "PALAREA") in view of U.S. Patent App. Pub. No. US 2016/0196398 A1 (hereinafter referred to as "Vivero").
Regarding (currently amended) claim 1, PALAREA teaches a method for performing an automated review of medical bills with surgical implants, the method comprising:
maintaining, by a processor of a billing review system (PALAREA: ¶ 0018; ¶ 0033), a database of surgical implant device information and associated pricing information (PALAREA: figure 3, i.e., profile database 206 includes “Part Identifiers” 310 and associated “Contract Price” 312; ¶ 0034; ¶ 0045-0049)…
receiving, by the processor of the billing review system, an electronic record for a medical bill (PALAREA: ¶ 0055, i.e., “a billing submission that is submitted to the processing server 102 and received by the receiving device 202”; ¶ 0056);
determining, by the processor of the billing review system, whether to review the electronic record for the medical bill based on information within the electronic record indicating use of a surgical implant device (PALAREA: ¶ 0018, i.e., “Health care devices may include implantable health care devices”; ¶ 0048, i.e., “Each part identifier 310 may be a unique value associated with a health care device”; ¶ 0057, i.e., “the processing server 102 may determine if the data included in the billing submission is valid. The determination…may be based on the data included in the billing submission…such as the procedure codes 308, part identifiers 310, and contract data 314. For example, the billing submission may be invalid if a part identifier 310 included in the billing submission is in an improper format or not accepted by the medical institution 104”);
in response to determining to review the electronic record for the medical bill, determining, by the processor of the billing review system, a price for the surgical implant device based on the electronic record for the medical bill and the database of surgical implant device information and associated pricing information (PALAREA: ¶ 0058, i.e., “If the billing submission is determined to be valid, then, in step 414, the identification module 218 may identify one or more notification rules that may be stored in the vendor profile 208 related to the vendor 106 involved in the sale of the health care devices for the medical procedure that may be applicable to the billing submission. The identification may also be based on the identification of the identification module 218 in determining compliance with the contract prices by the billing submission. The determination may be based on the billing prices included in the billing submission with the contract prices 312 associated with the part identifiers 310 that are included in the identified vendor profile 208”; ¶ 0065); and
providing, by the processor of the billing review system, through a graphical user interface (PALAREA: ¶ 0023; ¶ 0040; ¶ 0065), the determined price for the surgical implant device as a recommended payment amount for the surgical implant device (PALAREA: ¶ 0065, i.e., “indications 502 are included in the billing submission notification 500 to indicate that the billed price for the Full Knee is greater than the contract price for the health care device, and that the overall price that is billed is greater than the price that should be charged based on the contract”).
Yet, PALAREA does not explicitly teach, but Vivero teaches, in the same field of endeavor,
…the device information comprising historical pricing information based on the device type information associated with the surgical implant device, wherein the historical pricing information comprises, for each device, prices for the device over time, wherein the price for each device is adjusted for inflation over the period of time (Vivero: ¶ 0035, i.e., “Regarding personalized cost, treatment and outcome predictions, historical costs and outcome data for medical conditions, injuries, accidents, illnesses, procedures, surgeries, interventions, treatments, and so forth are computed from health insurance claims data. A user interface is presented for a user to input personal attributes (e.g., age, gender, location, insurance plan, and medical history) and select one or more conditions or procedures. Future costs, treatments, and outcomes are extrapolated by mapping the computed historical data to the user's attributes and adjusting them using additional external data sources (e.g., healthcare inflation index)”);
Therefore, it would have been obvious to one having ordinary skill in the art, before the effective filing date of the claimed invention, to include the device information comprising historical pricing information based on the device type information associated with the surgical implant device, wherein the historical pricing information comprises, for each device, prices for the device over time, wherein the price for each device is adjusted for inflation over the period of time, as taught by Vivero, within the system of PALAREA, with the motivation “to outline an expected set of events and costs for that person, should the person see a doctor for treatment” (Vivero: ¶ 0035).
Regarding (original) claim 2, PALAREA and Vivero teach the method of claim 1, wherein the information within the electronic record indicating use of a surgical implant device comprises information indicating a bill type (PALAREA: ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes…one or more procedure codes and/or procedure types associated with the medical procedure”).
Regarding (original) claim 3, PALAREA teaches the method of claim 1, wherein the information within the electronic record indicating use of a surgical implant device comprises one or more line items (PALAREA: ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes…billing prices for each health care device and/or the medical procedure”).
Regarding (original) claim 4, PALAREA teaches the method of claim 1, wherein the information within the electronic record indicating use of a surgical implant device comprises information indicating a body region (PALAREA: ¶ 0018, i.e., “Health care devices may include implantable health care devices, such as pacemakers, internal defibrillators, shunts, stents, total joints, bone screws, rods, artificial discs, pins, plates, rods, intra-uterine devices, tubes, lenses, etc.”; ¶ 0025, i.e., “procedure codes may include both primary codes and secondary codes, such as where a primary code may be associated with a type of procedure (e.g., knee replacement) and the secondary code associated with a subset of that procedure (e.g., whole knee replacement)”; ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes part identifiers for health care devices purchased as part of the medical procedure…one or more procedure codes and/or procedure types associated with the medical procedure”; ¶ 0048, i.e., “Each part identifier 310 may be a unique value associated with a health care device…e.g., each artificial knee may include a common part identifier”).
Regarding (original) claim 5, PALAREA teaches the method of claim 1, wherein the information within the electronic record indicating use of a surgical implant device comprises information indicating a type for the surgical implant device (PALAREA: ¶ 0018, i.e., “Health care devices may include implantable health care devices, such as pacemakers, internal defibrillators, shunts, stents, total joints, bone screws, rods, artificial discs, pins, plates, rods, intra-uterine devices, tubes, lenses, etc.”; ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes part identifiers for health care devices purchased as part of the medical procedure”; ¶ 0048, i.e., “Each part identifier 310 may be a unique value associated with a health care device…e.g., each artificial knee may include a common part identifier”).
Regarding (currently amended) claim 9, PALAREA teaches a system comprising:
a display device (PALAREA: ¶ 0023; ¶ 0040; ¶ 0065);
a processor coupled with the display device (PALAREA: ¶ 0018; ¶ 0033); and
a memory coupled with and readable by the processor and storing therein a set of instructions which, when executed by the processor, causes the processor (PALAREA: ¶ 0018; ¶ 0044) to:
maintain a database of surgical implant device information and associated pricing information (PALAREA: figure 3, i.e., profile database 206 includes “Part Identifiers” 310 and associated “Contract Price” 312; ¶ 0034; ¶ 0045-0049)…;
receive an electronic record for a medical bill (PALAREA: ¶ 0055, i.e., “a billing submission that is submitted to the processing server 102 and received by the receiving device 202”; ¶ 0056);
determine whether to review the electronic record for the medical bill based on information within the electronic record indicating use of a surgical implant device (PALAREA: ¶ 0018, i.e., “Health care devices may include implantable health care devices”; ¶ 0048, i.e., “Each part identifier 310 may be a unique value associated with a health care device”; ¶ 0057, i.e., “the processing server 102 may determine if the data included in the billing submission is valid. The determination…may be based on the data included in the billing submission…such as the procedure codes 308, part identifiers 310, and contract data 314. For example, the billing submission may be invalid if a part identifier 310 included in the billing submission is in an improper format or not accepted by the medical institution 104”);
in response to determining to review the electronic record for the medical bill, determine a price for the surgical implant device based on the electronic record for the medical bill and the database of surgical implant device information and associated pricing information (PALAREA: ¶ 0058, i.e., “If the billing submission is determined to be valid, then, in step 414, the identification module 218 may identify one or more notification rules that may be stored in the vendor profile 208 related to the vendor 106 involved in the sale of the health care devices for the medical procedure that may be applicable to the billing submission. The identification may also be based on the identification of the identification module 218 in determining compliance with the contract prices by the billing submission. The determination may be based on the billing prices included in the billing submission with the contract prices 312 associated with the part identifiers 310 that are included in the identified vendor profile 208”; ¶ 0065); and
provide, through a graphical user interface rendered on the display device (PALAREA: ¶ 0023; ¶ 0040; ¶ 0065), the determined price for the surgical implant device as a recommended payment amount for the surgical implant device (PALAREA: ¶ 0065, i.e., “indications 502 are included in the billing submission notification 500 to indicate that the billed price for the Full Knee is greater than the contract price for the health care device, and that the overall price that is billed is greater than the price that should be charged based on the contract”).
Yet, PALAREA does not explicitly teach, but Vivero teaches, in the same field of endeavor,
…the device information comprising historical pricing information based on the device type information associated with the surgical implant device, wherein the historical pricing information comprises, for each device, prices for the device over time, wherein the price for each device is adjusted for inflation over the period of time (Vivero: ¶ 0035, i.e., “Regarding personalized cost, treatment and outcome predictions, historical costs and outcome data for medical conditions, injuries, accidents, illnesses, procedures, surgeries, interventions, treatments, and so forth are computed from health insurance claims data. A user interface is presented for a user to input personal attributes (e.g., age, gender, location, insurance plan, and medical history) and select one or more conditions or procedures. Future costs, treatments, and outcomes are extrapolated by mapping the computed historical data to the user's attributes and adjusting them using additional external data sources (e.g., healthcare inflation index)”);
Therefore, it would have been obvious to one having ordinary skill in the art, before the effective filing date of the claimed invention, to include the device information comprising historical pricing information based on the device type information associated with the surgical implant device, wherein the historical pricing information comprises, for each device, prices for the device over time, wherein the price for each device is adjusted for inflation over the period of time, as taught by Vivero, within the system of PALAREA, with the motivation “to outline an expected set of events and costs for that person, should the person see a doctor for treatment” (Vivero: ¶ 0035).
Regarding (original) claim 10, claim 10 recites substantially similar limitations analogous to those already addressed in claim 2, and thus, claim 10 is similarly analyzed and rejected in a manner consistent with the rejection of claim 2.
Regarding (original) claim 11, claim 11 recites substantially similar limitations analogous to those already addressed in claim 3, and thus, claim 11 is similarly analyzed and rejected in a manner consistent with the rejection of claim 3.
Regarding (original) claim 12, claim 12 recites substantially similar limitations analogous to those already addressed in claim 4, and thus, claim 12 is similarly analyzed and rejected in a manner consistent with the rejection of claim 4.
Regarding (original) claim 13, claim 13 recites substantially similar limitations analogous to those already addressed in claim 5, and thus, claim 13 is similarly analyzed and rejected in a manner consistent with the rejection of claim 5.
Regarding (currently amended) claim 17, PALAREA teaches a non-transitory, computer-readable medium comprising a set of instructions stored therein which, when executed by a processor, causes the processor (PALAREA: ¶ 0018; ¶ 0044; ¶ 0086) to:
maintain a database of surgical implant device information and associated pricing information (PALAREA: figure 3, i.e., profile database 206 includes “Part Identifiers” 310 and associated “Contract Price” 312; ¶ 0034; ¶ 0045-0049)…;
receive an electronic record for a medical bill (PALAREA: ¶ 0055, i.e., “a billing submission that is submitted to the processing server 102 and received by the receiving device 202”; ¶ 0056);
determine whether to review the electronic record for the medical bill based on information within the electronic record indicating use of a surgical implant device (PALAREA: ¶ 0018, i.e., “Health care devices may include implantable health care devices”; ¶ 0048, i.e., “Each part identifier 310 may be a unique value associated with a health care device”; ¶ 0057, i.e., “the processing server 102 may determine if the data included in the billing submission is valid. The determination…may be based on the data included in the billing submission…such as the procedure codes 308, part identifiers 310, and contract data 314. For example, the billing submission may be invalid if a part identifier 310 included in the billing submission is in an improper format or not accepted by the medical institution 104”);
in response to determining to review the electronic record for the medical bill, determine a price for the surgical implant device based on the electronic record for the medical bill and the database of surgical implant device information and associated pricing information (PALAREA: ¶ 0058, i.e., “If the billing submission is determined to be valid, then, in step 414, the identification module 218 may identify one or more notification rules that may be stored in the vendor profile 208 related to the vendor 106 involved in the sale of the health care devices for the medical procedure that may be applicable to the billing submission. The identification may also be based on the identification of the identification module 218 in determining compliance with the contract prices by the billing submission. The determination may be based on the billing prices included in the billing submission with the contract prices 312 associated with the part identifiers 310 that are included in the identified vendor profile 208”; ¶ 0065); and
provide, through a graphical user interface (PALAREA: ¶ 0023; ¶ 0040; ¶ 0065), the determined price for the surgical implant device as a recommended payment amount for the surgical implant device (PALAREA: ¶ 0065, i.e., “indications 502 are included in the billing submission notification 500 to indicate that the billed price for the Full Knee is greater than the contract price for the health care device, and that the overall price that is billed is greater than the price that should be charged based on the contract”).
Yet, PALAREA does not explicitly teach, but Vivero teaches, in the same field of endeavor,
…the device information comprising historical pricing information based on the device type information associated with the surgical implant device, wherein the historical pricing information comprises, for each device, prices for the device over time, wherein the price for each device is adjusted for inflation over the period of time (Vivero: ¶ 0035, i.e., “Regarding personalized cost, treatment and outcome predictions, historical costs and outcome data for medical conditions, injuries, accidents, illnesses, procedures, surgeries, interventions, treatments, and so forth are computed from health insurance claims data. A user interface is presented for a user to input personal attributes (e.g., age, gender, location, insurance plan, and medical history) and select one or more conditions or procedures. Future costs, treatments, and outcomes are extrapolated by mapping the computed historical data to the user's attributes and adjusting them using additional external data sources (e.g., healthcare inflation index)”);
Therefore, it would have been obvious to one having ordinary skill in the art, before the effective filing date of the claimed invention, to include the device information comprising historical pricing information based on the device type information associated with the surgical implant device, wherein the historical pricing information comprises, for each device, prices for the device over time, wherein the price for each device is adjusted for inflation over the period of time, as taught by Vivero, within the system of PALAREA, with the motivation “to outline an expected set of events and costs for that person, should the person see a doctor for treatment” (Vivero: ¶ 0035).
Regarding (original) claim 18, PALAREA teaches the non-transitory, computer-readable medium of claim 17, wherein the information within the electronic record indicating use of a surgical implant device comprises one or more of information indicating a bill type (PALAREA: ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes…one or more procedure codes and/or procedure types associated with the medical procedure”), one or more codes (PALAREA: ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes…one or more procedure codes and/or procedure types associated with the medical procedure”), information indicating a body region (PALAREA: ¶ 0018, i.e., “Health care devices may include implantable health care devices, such as pacemakers, internal defibrillators, shunts, stents, total joints, bone screws, rods, artificial discs, pins, plates, rods, intra-uterine devices, tubes, lenses, etc.”; ¶ 0025, i.e., “procedure codes may include both primary codes and secondary codes, such as where a primary code may be associated with a type of procedure (e.g., knee replacement) and the secondary code associated with a subset of that procedure (e.g., whole knee replacement)”; ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes part identifiers for health care devices purchased as part of the medical procedure…one or more procedure codes and/or procedure types associated with the medical procedure”; ¶ 0048, i.e., “Each part identifier 310 may be a unique value associated with a health care device…e.g., each artificial knee may include a common part identifier”), or information indicating a type for the surgical implant device (PALAREA: ¶ 0018, i.e., “Health care devices may include implantable health care devices, such as pacemakers, internal defibrillators, shunts, stents, total joints, bone screws, rods, artificial discs, pins, plates, rods, intra-uterine devices, tubes, lenses, etc.”; ¶ 0030, i.e., “Billing submissions may include data related to a medical procedure that includes part identifiers for health care devices purchased as part of the medical procedure”; ¶ 0048, i.e., “Each part identifier 310 may be a unique value associated with a health care device…e.g., each artificial knee may include a common part identifier”).
Claim(s) 6-8, 14-16, 19-20 is/are rejected under 35 U.S.C. 103 as being unpatentable over U.S. Patent App. Pub. No. US 2016/0063199 A1 (hereinafter referred to as "PALAREA") in view of U.S. Patent App. Pub. No. US 2016/0196398 A1 (hereinafter referred to as "Vivero"), as applied to claims 1-5, 9-13, 17-18, further in view of U.S. Patent App. Pub. No. US 2019/0139012 A1 (hereinafter referred to as "Kube, II").
Regarding (previously presented) claim 6, PALAREA and Vivero teach the method of claim 1, wherein determining the price for the surgical implant device based on the electronic record for the medical bill and the database of surgical implant device information and associated pricing information comprises:
reading, from the electronic record for the medical bill, information for the surgical implant device and surgical procedure (PALAREA: ¶ 0057, i.e., “the processing server 102 may determine if the data included in the billing submission is valid. The determination…may be based on the data included in the billing submission…such as the procedure codes 308, part identifiers 310, and contract data 314”);
querying the database of surgical implant device information and associated pricing information for device type information associated with the surgical implant device (PALAREA: figure 3, i.e., profile database 206 includes “Part Identifiers” 310; ¶ 0057, i.e., “The determination…may be based on the data included in the billing submission as compared to data included in the vendor profile 106 associated with the involved vendor 106 (e.g., as identified from the profile database 206 by the querying module 220)”);
querying the database of surgical implant device information and associated pricing information for device data for the surgical implant device (PALAREA: figure 3, i.e., profile database 206 includes “Contract Price” 312 for “Part Identifiers” 310; ¶ 0049; ¶ 0057, i.e., “The determination…may be based on the data included in the billing submission as compared to data included in the vendor profile 106 associated with the involved vendor 106 (e.g., as identified from the profile database 206 by the querying module 220)”);
Yet, PALAREA and Vivero does not explicitly teach, but Kube, II teaches, in the same field of endeavor,
applying one or more predefined requirements to the device data (Kube, II: ¶ 0033, i.e., “In the universal chargemaster database, a charge (or a fee) is attached to each medical billing code based upon researched data for the usual and customary price for a medical billing code in a healthcare provider's geographic area”; ¶ 0044, i.e., “Upon recognition of the custom code 42 (step 100), the integration module 18 retrieves the standard charge rates for the CPT codes that are listed as EHE-related medical billing code(s) in the unique identifier (step 102). The integration module 18 queries the universal chargemaster database 24 and medical billing code database 26 to generate, or otherwise calculate, a universal charge rate for the EHE”); and
generating a price for a line item of the electronic record for the medical bill based on the one or more predefined requirements applied to the device data (Kube, II: ¶ 0046, i.e., “The integration module 18 then applies a discount to the universal charge rate”).
Therefore, it would have been obvious to one having ordinary skill in the art, before the effective filing date of the claimed invention, to include applying one or more predefined requirements to the device data; and generating a price for a line item of the electronic record for the medical bill based on the one or more predefined requirements applied to the device data, as taught by Kube, II, with the system of PALAREA and Vivero, with the motivation of “ensures accurate accounting and compliance with medical billing regulations” (Kube, II: ¶ 0047).
Regarding (original) claim 7, PALAREA, Vivero, and Kube, II teach the method of claim 6, wherein the one or more predefined requirements comprise a fee schedule (Kube, II: ¶ 0045, i.e., “The integration module 18 queries the payor fee schedule database and retrieves the appropriate payor contract rate for the EHE”).
The obviousness of combining the teachings of PALAREA, Vivero, and Kube, II are discussed in the rejection of claim 6, and incorporated herein.
Regarding (original) claim 8, PALAREA, Vivero, and Kube, II teach the method of claim 6, wherein the one or more predefined requirements comprise a definition of usual, customary, and reasonable pricing (Kube, II: ¶ 0033, i.e., “In the universal chargemaster database, a charge (or a fee) is attached to each medical billing code based upon researched data for the usual and customary price for a medical billing code in a healthcare provider's geographic area”).
The obviousness of combining the teachings of PALAREA, Vivero, and Kube, II are discussed in the rejection of claim 6, and incorporated herein.
Regarding (previously presented) claim 14, claim 14 recites substantially similar limitations analogous to those already addressed in claim 6, and thus, claim 14 is similarly analyzed and rejected in a manner consistent with the rejection of claim 6.
Regarding (original) claim 15, claim 15 recites substantially similar limitations analogous to those already addressed in claim 7, and thus, claim 15 is similarly analyzed and rejected in a manner consistent with the rejection of claim 7.
Regarding (original) claim 16, claim 16 recites substantially similar limitations analogous to those already addressed in claim 8, and thus, claim 16 is similarly analyzed and rejected in a manner consistent with the rejection of claim 8.
Regarding (previously presented) claim 19, claim 19 recites substantially similar limitations analogous to those already addressed in claim 6, and thus, claim 19 is similarly analyzed and rejected in a manner consistent with the rejection of claim 6.
Regarding (original) claim 20, PALAREA, Vivero, and Kube, II teach the non-transitory, computer-readable medium of claim 19, wherein the one or more predefined requirements comprise one or more of a fee schedule (Kube, II: ¶ 0045, i.e., “The integration module 18 queries the payor fee schedule database and retrieves the appropriate payor contract rate for the EHE”) or a definition of usual, customary, and reasonable pricing (Kube, II: ¶ 0033, i.e., “In the universal chargemaster database, a charge (or a fee) is attached to each medical billing code based upon researched data for the usual and customary price for a medical billing code in a healthcare provider's geographic area”).
The obviousness of combining the teachings of PALAREA, Vivero, and Kube, II are discussed in the rejection of claim 6, and incorporated herein.
Response to Arguments
Applicant's arguments filed 09/22/2026 have been fully considered but they are not persuasive. Applicant’s arguments will be addressed hereinbelow in the order in which they appear in the response filed 09/22/2026.
In the remarks, Applicant argues in substance that:
Regarding the 101 rejections,
“amendments have been made herein that are thought to fully address the reasons for the rejection or otherwise render the rejection moot.”
Regarding the 103 rejections, the cited prior art reference(s) fails to teach the amended claim limitations.
It is respectfully submitted that Examiner has considered Applicant’s arguments and does not find them persuasive. Examiner has attempted to address all of the arguments presented by Applicant; however, any arguments inadvertently not addressed are not persuasive for at least the following reasons:
In response to Applicant’s argument that (a) regarding the 101 rejections,
“amendments have been made herein that are thought to fully address the reasons for the rejection or otherwise render the rejection moot”:
It is respectfully submitted that Examiner maintains the 101 rejections of claims 1-20, which have been updated to address Applicant’s remarks and to comply with the 2019 Revised Patent Subject Matter Eligibility Guidance and the 2024 Guidance Update on Patent Subject Matter Eligibility, Including on Artificial Intelligence in the above Office Action.
In response to Applicant’s argument that (b) regarding the 103 rejections, the cited prior art reference(s) fails to teach the amended claim limitations:
It is respectfully submitted that Examiner has updated passages and citations to the amended claims and applied new passages and citations accordingly, at the present time, as addressed in the above Office Action, and the analogous independent claims and the remaining dependent claims have been taught by the applied/recited passages and citations, as addressed in the above Office Action.
Thus, the cited prior art references teach the aforementioned amended claim limitations.
Conclusion
THIS ACTION IS MADE FINAL. Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a).
A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to Emily Huynh whose telephone number is (571)272-8317. The examiner can normally be reached on M-Th 8-5 PM.
Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice.
If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Robert Morgan can be reached on (571) 272-6773.The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300.
Information regarding the status of an application may be obtained from the Patent Application Information Retrieval (PAIR) system. Status information for published applications may be obtained from either Private PAIR or Public PAIR. Status information for unpublished applications is available through Private PAIR only. For more information about the PAIR system, see http://pair-direct.uspto.gov. Should you have questions on access to the Private PAIR system, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative or access to the automated information system, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000.
/EMILY HUYNH/Primary Examiner, Art Unit 3683
